How should NPOs
measure their work and its results? This article
reports on one organizations experience in
developing better performance measures. The
Christian Childrens Fund (CCF) (see sidebar
below) put together what it calls its annual
impact monitoring and evaluation system (AIMES).
For organizations of this type, accountability is
extremely important. CPAs can use outcome
measures to help similar organizations achieve
their goal-driven strategic plans.
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Christian Childrens Fund Founded
in 1938, CCF (www.christianchildrensfund.org)
is an international child care agency
serving the health and educational needs
of impoverished children worldwide. It
provides services to approximately 2.5
million children in 31 countries,
including the United States. CCF programs
promote long-term sustainable development
by providing children with safer lives
due to improved access to health care and
safe water, immunizations, better
nutrition, educational assistance,
literacy courses, skills training and
other services specific to their
individual needs.
Approximately 80% of CCFs
revenues come from a program of
child sponsorship, in which
individual donors are linked with a
specific child. The program sponsors over
400,000 children worldwide. About 75% of
the sponsors are from the United States.
Revenues for the last fiscal year were
approximately $127 million.
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HOW DO YOU SPELL SUCCESS?
One approach CPAs might use to
judge an NPOs performance is to measure the
amount of resources the organization spends on
providing program services (to carry out its
purpose) vs. what it spends on management and
general expenses and fundraising. For most
organizations, a higher percentage of resources
spent on program services than on management and
fundraising is considered a positive performance
indicator. Tax-exempt organizations are required
to file IRS Form 990, Return of Organization
Exempt From Income Tax, annually. It
includes the amount of resources the organization
received and how it spent them. Several watchdog
organizations use these data to track and rate
NPO performance.
Although this type of measure
is useful, it doesnt indicate how
effectively an organization uses its resources to
meet its objectives. For example, an NPO may
spend 80% of its resources providing a particular
program service, but may be ineffective in
reaching the programs goals. Just spending
money on a service is not an effective
performance measure.
FASB recognizes the limitations
of traditional financial statements in assessing
NPO performance. In Concepts Statement no. 4, Objectives
of Financial Reporting by Nonbusiness
Organizations, FASB saw the need for a
different type of information to measure their
performance. The statement calls for reporting
information about service efforts (how an NPO
uses resources to provide different programs or
services) in the financial statements. Concepts
Statement no. 4 also says that, ideally, NPOs
should provide information about service
accomplishments as part of financial reporting.
It recognizes the difficulties organizations face
in measuring and reporting program
accomplishments. and acknowledges the need for
more research to determine whether service effort
and accomplishment measurements can be developed
that meet the characteristics necessary to be
included in NPO financial statements.
OUTPUT
AND OUTCOME MEASURES
Service efforts and
accomplishment measures fall into four
categories: input measures, output measures,
outcome measures and efficiency measures. They
quantify the effort expended on a program
(inputs), the level of services provided
(outputs), the effect a service has on the
programs stated objectives (outcomes) and a
comparison of the level of inputs with outputs or
outcomes (efficiency).
NPOs are very accustomed to
reporting input measures. For example, they
report the financial resources dedicated to
specific programs in their financial statements.
Many also report nonfinancial information about
the effort they expend, such as the hours spent
meeting a program goal.
Output measures are often
stated in nonfinancial terms. For example, a
university may report the number of students that
graduated or a homeless shelter may report the
number of people housed.
Outcome measures gauge how well
a program accomplished its goal. For example, a
program designed to teach reading to adults may
use the literacy rate for the area served as an
outcome measure. One limitation of outcome
measures is many factors other than a specific
program can effect them. However, when they are
used over a period of time, CPAs will find they
can be a key way to measure a programs
effectiveness.
Often, the final step an NPO
can take in using service efforts and
accomplishments techniques is to employ them to
measure efficiency. These measures compute either
inputs/outputs or inputs/outcomes indicators and
provide information on how efficient an
organization is at achieving its program goals.
For example, a program that teaches reading to
adults could compute a cost (input) for each
adult who reaches a certain reading level
(output).
Most NPOs are still in the
early stages of developing output and outcome
measures. However, the CCF focused its AIMES on
measurable, standardized outputs and outcomes
that would allow it to make comparisons among
communities as well as among the different
countries it serves.
THE
CCF MODEL
In 1995, the CCF began working
on an evaluation system to assess whether its
programs were making a positive, measurable
difference in the lives of children and their
communities around the world. It established a
working group that included national directors
and program managers as well as representatives
from sponsor services, finance and internal
audit. The group also had the support of an
outside consultant. CCF thus developed its
evaluation system through intense dialogue and
considerable input from the field. The system was
designed both to allow CCF to be more accountable
to its sponsors and to give communities a tool to
continually assess the impact CCF projects were
having on children and families.
CCF wanted a tool that would
measure the effectiveness of its health and
education programs. The organization operates
many different programs in a variety of locations
and individual content may vary based on local
needs. For example, in 1997, CCFs
evaluation system captured the health status and
educational progress of 1,865,194 children in
approximately 850 projects in 18 countries.
AIMES uses a set of
standardized health and education indicators (see
exhibit
1) to measure impact
(outcome) and process (output). The three impact
indicators measure progress toward
childrens well-beingCCFs basic
goal. The seven process indicators measure how
outputs effect a positive change in three core
impact areas. While local projects may add other
performance measures, AIMES measures are standard
for all projects.
| Exhibit 1:
Core Standardized Outcome/Output Measures
for AIMES |
AIMES
Impact
Indicators |
Under-5-year-old
mortality. Under-5-year-old
moderate and severe malnutrition.
Adult
literacy.
|
AIMES
Process
Indicators |
One- to
two-year-old immunized. Tetanus
Toxoid vaccine (TT2) protected
live births.
Families
that correctly know how to manage
a case of diarrhea.
Families
that correctly know how to manage
acute respiratory infection.
Families
that have access to safe water.
Families
that practice safe sanitation.
Boys/girls
who are enrolled in a formal or
nonformal educational program.
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In selecting
what to measure, CCF identified core indicators
that it deemed critical success factors for all
projects. For a measure to be included as a core
indicator, CCF developed four qualitative
requirements. The measures should
Focus on program impact,
not activities.
Gauge the programs impact on
children, except where there was a proven
association between a child outcome and the
ability of the person caring for that child.
Determine impact in terms of broadly
defined health and educational outcomes.
Assess only what CCF was able and
prepared to track.
Once CCF developed the
performance measures, it field-tested them in 10
program countries on several key projects. The
next step was training staff in all national
offices on how to use the system. This two-year
process proved essential in producing reliable
and consistent performance measures as well as
ensuring the measures were understood at the
local level.
Although AIMES captures the
impact and process measurements in communities,
it does not prescribe any strategy for a
community program, nor does it place any limits
on the kinds of programs a community can use to
promote the well-being of children. However,
communities can use the information to make
decisions about how best to set priorities for
initiatives, allocate resources and take
follow-up actions. In this way, AIMES becomes a
tool for monitoring, planning and managing
programs. For example, if the malnutrition rate
for children under age five in a community is
found to be very high, addressing this problem
becomes a priority. The local CCF unit can decide
how to best reduce child malnutrition by
educating caregivers on improved feeding
practices, providing supplementary diet material
or improving access to clean water.
CCF collected the data for
AIMES in a systematic and consistent manner. The
family card is a key source document
for the fund because it captures information on
each performance indicator. There is one card for
each family in a CCF program in a given
community. Project staff and community volunteers
maintain contact with each family through
periodic visits to update information on the
card, provide health messages and offer
on-the-spot guidance on other areas of concern.
CCF collects additional
information through regular home visits and
records it on service rosters and vital event
registers. Once a year, all the data are combined
into a one-page report for each community then
further aggregated by each national office and
then in total. Thus, the system provides
information at the community, national and
organizational level. Having information
aggregated at different levels enables managers
to compare performance indicators among
communities and countries. Managers can also
track improvements over time. Exhibit 2, below, shows the AIMES indicators for
1997 to 1999, aggregated for the entire
organization. Exhibit 3, at
the end of this article, presents the same
information in a bar graph.
| Exhibit 2:
Progress Made on Core Indicators |
| Indicators |
1997
Data |
1998
Data |
1999
Data |
| *Under-5-year-old
mortality per 1,000 births |
76 |
76 |
72 |
| *Under-5-year-old
moderate to severely malnourished |
13% |
13% |
11% |
| Literate
men |
77% |
79% |
80% |
| Literate
women |
68% |
69% |
71% |
| 1 to
2-year-old immunized |
69% |
76% |
76% |
| Tetanus
Toxoid vaccine (TT2) protected
live births |
N/A |
78% |
78% |
| Manage
diarrhea |
81% |
84% |
88% |
| Manage
respiratory infections |
69% |
75% |
80% |
| Access to
safe water |
74% |
78% |
80% |
| Safe
sanitation practice |
63% |
67% |
70% |
| 0 to 5
education enrollment |
44% |
51% |
55% |
| 5 to 15
education enrollment |
89% |
91% |
92% |
| *Expected
decreases |
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The initial
response within CCF to the AIMES approach has
been very positive. The system is now in place in
more than 1,000 projects in 20 countries.
Tracking a set of core health and education
performance indicators has made project managers
more focused and better able to concentrate
resource allocations on areas that can make a
measurable difference in outcomes affecting the
lives of the parents and children in their local
communities. CCF can use performance indicators
to make meaningful comparisons among communities
within a country as well as over time. It then
can use this information to make program and
resource decisions at the community level.
Collecting and reporting data
for each community has had other benefits for
CCF. The family card, an important tool in the
system, has proved useful in monitoring vital
events and progress in childrens health and
educational development. In addition, increased
participation by parents and community volunteers
in these visits has led to more meaningful
contacts between projects and communities and
improved understanding of the caregivers. For
example, growth monitoring to track the nutrition
status of young children has helped promote
appropriate feeding and child care practices.
MAKING
IT WORK FOR YOU
Can such a performance
measurement system work for a museum, school or
community welfare organization? CPAs will find
that developing a system similar to the one CCF
used can be a fairly straightforward process for
most organizations. There are four basic steps to
follow in creating a performance measurement
system that focuses on outputs and outcomes.
Clearly identify the
organizations mission.
Developed qualitative requirements
for indicators and measurements.
Develop primary indicators and
measurements.
Implement the new performance
measurement system.
An organizations first
step is to clearly identify its mission or
purpose. What role does the organization play in
society? What benefits should it provide to its
community? What impact should it have on the
community? An NPO can use its understanding of
its clearly defined purpose to help drive the
creation of meaningful output/outcome performance
measurements.
The second step is to identify
basic qualitative requirements to guide the
development of the output/outcome measures. These
requirements represent overarching guidelines
under which the NPO develops each measurable
output/outcome. They help ensure the
organizations performance indicators are
appropriately linked with the content of its
mission statement. For example, CCF found it was
important for performance indicators to focus on
the impact (outcome) its programs were having on
the children it was serving. One important
consideration in developing performance measures
is to make sure the organization has the time,
resources and availability to track these
output/outcomes measures. Some small NPOs may
not.
The actual development of the
performance measures is the third step. Its
critical to involve managers and employees from
throughout the organization in identifying a
workable number of measurements that will serve
as primary indicators of how well the NPO is
meeting its mission. Employee input will provide
valuable insight as well as enhance support for
using the performance indicators when they are
finalized. The performance indicators must also
be field-tested before implementation. Past
experience suggests that between 5 and 10 broadly
defined indicators are often sufficient to
measure how well an organization is meeting its
goals and objectives.
The fourth step an NPO should
take is to implement the performance measures.
The goal is to provide information that will help
managers better focus on resource
allocationsto assist them in making
decisions that will help the organization fulfill
its mission. Once the system has collected
baseline data, the organization will have a
benchmark to track progress over time. As with
the CCF, such a system should result in a better
linkage between resource decisions and the
outcomes the organization wishes to achieve.
AN
IMPORTANT TOOL
The CCFs development of
AIMES has improved the organizations
accountability and become a tool for monitoring,
planning and managing programs. CCF provides
measures that reflect the impact of programs on
the lives of young children and their
communities. The system has enhanced the
organizations ability to meet its goals by
monitoring and reporting project performance
aggregated at the community, national and
organizational levels. One of the systems
biggest contributions is a clearer sense of
purpose, which allows CCF managers to better
focus resources on the organizations goals.
For example, CCF has shifted resources from
programs concentrating on school-age children to
early childhood interventions, maternal health
care and support for caregivers.
In sum, AIMES provides CCF with
a viable instrument for program management by
allowing communities to make decisions about
program priorities and resource allocations
needed to reach the organizations goals.
CPAs who work for NPOs can use the principles
behind AIMES to help their own organizations
develop meaningful performance measures that will
enable them to meet their own goals and
objectives. 
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